Social determinants of breastfeeding in Italy.

BACKGROUND: Breastfeeding is surely the best way to feed an infant at least in the first six months of life. OBJECTIVE: To investigate the social determinants of breastfeeding behaviors among Italian women. METHODS: Data for this study were drawn from the Italian Institute of Statistics (ISTAT) survey conducted in 2005 which comprised a nationally representative sample of 50,474 households (128,040 subjects). This 2005 ISTAT survey asked several questions to women who delivered (n = 5,812) in the past five years prior to the survey about their breastfeeding behaviours. Breastfeeding initiation rate and duration for ≥ six months were our main dependent variables while independent variables included socio demographics and health-related factors. Descriptive statistics, Pearson chi-squared test and multiple logistic regressions were performed. RESULTS: Our sample comprised 5,812 women. Rates of breastfeeding initiation and duration for e″ six months were respectively 82.0 percent and 70.0 percent. Social determinants of breastfeeding initiation were older ages (OR: 1.029, p = 0.019) and employment status (OR: 1.289, p = 0.032). No social factor was associated to breastfeeding duration. CONCLUSION: Rates of breastfeeding initiation and duration in Italy are rather high. Age and employment status were the main social determinants (breastfeeding initiation) found.

A simplified and less expensive strategy for confirming anti HIV-1 screening results in a diagnostic laboratory in Lubumbashi, Zaire.

The conventional algorithm for HIV testing based on the confirmation of all positive anti-HIV screening reactions by Western blot (WB) is too expensive for developing countries. We investigated the validity of confirming positive screening assay reactions by a second screening test, limiting the use of the supplemental assay to the discrepant test results (algorithm 3), or screening all sera with 2 different assays and retesting all discrepant results by a supplemental assay (algorithm 4) on a panel of 519 sera in a regional reference laboratory in Lubumbashi, Zaire. Combining the Vironostika anti-HTLV-III ELISA with HIV Chek 1 + 2 or Clonatec Rapid HIV 1/2 Ab on all samples and retesting the discrepant results in WB or a line immunoassay (INNO-LIA) (algorithm 4), yielded a sensitivity of 100% and specificities of 98.4% and 99.0% respectively, at costs of 7.3 US $ and 9.3 US $ per test, respectively, for a 40% prevalence of HIV antibody positive samples. The conventional algorithm scored a sensitivity of 97.1% and a specificity of 100% for 11.3 US $ per test. The testing strategy of combining HIV Chek 1 + 2 and Clonatec Rapid HIV 1/2 Ab, an interesting option for small isolated centra, had a 96.6% sensitivity, but yielded only a slightly better specificity of 99.0%, as compared to 97.8% for HIV Chek alone. The price of combining the two simple assays using algorithm 3 was 6.8 US $ per test, using algorithm 4 was 10.6 US $. HIV testing strategies based on ELISA and a simple HIV test are a valuable alternative for reference laboratories faced with a high prevalence of HIV positive samples.